Noncontrast MRA (magnetic resonance angiogram) neck radiology search pattern

Another frequent study will encounter in neuroradiology is an MRA (magnetic resonance angiogram) of the neck. This test is frequently used to evaluate the arteries of the neck, including the carotid and vertebral arteries.

MRA of the neck can be performed without contrast using a technique called time of flight imaging, which depends on signal from flowing blood to create the image. MRA of the neck can also be performed with contrast in certain situations, such as need to better evaluate the aortic arch and great vessel origins or need to imaging dynamically.

MRA of the neck is primarily used to evaluate for vessel occlusion or narrowing, although vascular malformations may also be evaluated. It can also be used to follow up on vascular findings seen on other studies, such as doppler ultrasound of the carotids. The most common indication, however, is to evaluate for stroke, when it is combined with MRI and MRA of the brain.

This video will walk you through a step-by-step approach to evaluating an MRA of the neck, including how to approach each vessel. I use an approach that moves from anterior to posterior and then right to left. While others may have a different strategy, the most important part is to have a strategy and stick to it.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in neuroradiology or may see patients with atherosclerotic disease or stroke.

See this and other videos on our Youtube channel.